Part 3A: Responding to abuse and neglect

Presentations of abuse in general practice are seldom clear-cut and well-defined, and different types of abuse can overlap in the same child or adult. The context for concerns is often more important than the identification of an 'incident'. Safeguarding is often likened to a jigsaw puzzle. Often, it is only when individuals and agencies share information together that the picture is complete. This involves effective record keeping, information-sharing and communication, both internally and between agencies.

Building up a picture of what is life is like for a child, or an adult at risk of harm is key to keeping them safe, alongside ensuring that the ‘voice’ of the child or adult is central to everything that we do.

As outlined in the previous section of the toolkit, ‘Identification of abuse and neglect’, abuse can present in lots of different ways to general practice. There are many similarities to the presentations of the different types of abuse. For example, mental health difficulties can be a common presentation of all types of abuse in children or adults.

As GPs we have a unique and privileged role. Patients and their families allow us into their lives, often at times of great distress, in order to support and help them. This is a great privilege, which comes with great responsibility. The area of safeguarding is an area of clinical care where these two roles, privilege and responsibility, very clearly meet. Combining these roles enables us to be powerful advocates for our most vulnerable patients.